|
PR STENGER TEST PURE TONE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 92565
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$32.87 |
| Rate for Payer: Aetna Commercial |
$27.47
|
| Rate for Payer: Aetna Medicare |
$21.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.52
|
| Rate for Payer: BCBS MAPPO |
$20.50
|
| Rate for Payer: BCN Commercial |
$32.87
|
| Rate for Payer: BCN Medicare Advantage |
$20.50
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$27.47
|
| Rate for Payer: Cofinity Commercial |
$29.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$20.50
|
| Rate for Payer: PHP Commercial |
$28.70
|
| Rate for Payer: PHP Medicare Advantage |
$20.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.31
|
| Rate for Payer: Priority Health Medicare |
$20.50
|
| Rate for Payer: Priority Health SBD |
$30.31
|
| Rate for Payer: Priority Health Tiered Network |
$30.31
|
| Rate for Payer: Railroad Medicare Medicare |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.44
|
| Rate for Payer: UHC Core |
$23.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.50
|
| Rate for Payer: UHC Exchange |
$23.44
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
PR STENGER TEST SPEECH
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 92577
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: Aetna Commercial |
$27.89
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCN Commercial |
$34.36
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$29.97
|
| Rate for Payer: Cofinity Commercial |
$27.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Nomi Health Commercial |
$24.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$29.13
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.69
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health SBD |
$31.69
|
| Rate for Payer: Priority Health Tiered Network |
$31.69
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.79
|
| Rate for Payer: UHC Core |
$20.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.81
|
| Rate for Payer: UHC Exchange |
$20.79
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
|
PR STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 36908
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Aetna Commercial |
$245.09
|
| Rate for Payer: Aetna Medicare |
$190.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.38
|
| Rate for Payer: BCBS Complete |
$121.66
|
| Rate for Payer: BCBS MAPPO |
$182.90
|
| Rate for Payer: BCN Commercial |
$302.28
|
| Rate for Payer: BCN Medicare Advantage |
$182.90
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cofinity Commercial |
$245.09
|
| Rate for Payer: Cofinity Commercial |
$263.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.04
|
| Rate for Payer: Meridian Medicaid |
$121.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.19
|
| Rate for Payer: Nomi Health Commercial |
$219.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.75
|
| Rate for Payer: PACE SWMI |
$182.90
|
| Rate for Payer: PHP Commercial |
$256.06
|
| Rate for Payer: PHP Medicare Advantage |
$182.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$325.05
|
| Rate for Payer: Priority Health Medicare |
$182.90
|
| Rate for Payer: Priority Health SBD |
$325.05
|
| Rate for Payer: Priority Health Tiered Network |
$325.05
|
| Rate for Payer: Railroad Medicare Medicare |
$182.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$371.91
|
| Rate for Payer: UHC Core |
$371.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$182.90
|
| Rate for Payer: UHC Exchange |
$371.91
|
| Rate for Payer: UHC Medicaid |
$115.87
|
| Rate for Payer: UHCCP Medicaid |
$115.87
|
| Rate for Payer: UMR Bronson Commercial |
$272.78
|
|
|
PR STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS G6002
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$113.04 |
| Rate for Payer: Aetna Commercial |
$85.81
|
| Rate for Payer: Aetna Commercial |
$85.81
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Aetna Medicare |
$74.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.81
|
| Rate for Payer: BCBS Complete |
$59.60
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCN Commercial |
$113.04
|
| Rate for Payer: BCN Commercial |
$113.04
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.75
|
| Rate for Payer: UMR Bronson Commercial |
$68.54
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
PR STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES
|
Professional
|
Both
|
$3,065.00
|
|
|
Service Code
|
HCPCS 61750
|
| Min. Negotiated Rate |
$883.52 |
| Max. Negotiated Rate |
$2,974.80 |
| Rate for Payer: Aetna Commercial |
$1,848.78
|
| Rate for Payer: Aetna Medicare |
$1,434.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,848.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,986.75
|
| Rate for Payer: BCBS Complete |
$927.70
|
| Rate for Payer: BCBS MAPPO |
$1,379.69
|
| Rate for Payer: BCN Commercial |
$2,974.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.69
|
| Rate for Payer: Cash Price |
$2,452.00
|
| Rate for Payer: Cash Price |
$2,452.00
|
| Rate for Payer: Cofinity Commercial |
$1,986.75
|
| Rate for Payer: Cofinity Commercial |
$1,848.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.67
|
| Rate for Payer: Meridian Medicaid |
$927.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.66
|
| Rate for Payer: Nomi Health Commercial |
$1,655.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,298.75
|
| Rate for Payer: PACE SWMI |
$1,379.69
|
| Rate for Payer: PHP Commercial |
$1,931.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,500.98
|
| Rate for Payer: Priority Health Medicare |
$1,379.69
|
| Rate for Payer: Priority Health SBD |
$2,500.98
|
| Rate for Payer: Priority Health Tiered Network |
$2,500.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,479.34
|
| Rate for Payer: UHC Core |
$2,479.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,379.69
|
| Rate for Payer: UHC Exchange |
$2,479.34
|
| Rate for Payer: UHC Medicaid |
$883.52
|
| Rate for Payer: UHCCP Medicaid |
$883.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,409.90
|
|
|
PR STEREOTACTIC COMPUTER ASSISTED PX SPINAL
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 61783
|
| Min. Negotiated Rate |
$132.27 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$280.68
|
| Rate for Payer: Aetna Medicare |
$217.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.62
|
| Rate for Payer: BCBS Complete |
$138.88
|
| Rate for Payer: BCBS MAPPO |
$209.46
|
| Rate for Payer: BCN Commercial |
$347.09
|
| Rate for Payer: BCN Medicare Advantage |
$209.46
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$280.68
|
| Rate for Payer: Cofinity Commercial |
$301.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.93
|
| Rate for Payer: Meridian Medicaid |
$138.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$230.41
|
| Rate for Payer: Nomi Health Commercial |
$251.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$209.46
|
| Rate for Payer: PHP Commercial |
$293.24
|
| Rate for Payer: PHP Medicare Advantage |
$209.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$403.15
|
| Rate for Payer: Priority Health Medicare |
$209.46
|
| Rate for Payer: Priority Health SBD |
$403.15
|
| Rate for Payer: Priority Health Tiered Network |
$403.15
|
| Rate for Payer: Railroad Medicare Medicare |
$209.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.02
|
| Rate for Payer: UHC Core |
$415.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$209.46
|
| Rate for Payer: UHC Exchange |
$415.02
|
| Rate for Payer: UHC Medicaid |
$132.27
|
| Rate for Payer: UHCCP Medicaid |
$132.27
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES
|
Professional
|
Both
|
$8,565.00
|
|
|
Service Code
|
HCPCS 61798
|
| Min. Negotiated Rate |
$853.49 |
| Max. Negotiated Rate |
$6,423.75 |
| Rate for Payer: Aetna Commercial |
$1,789.69
|
| Rate for Payer: Aetna Medicare |
$1,389.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,789.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,923.25
|
| Rate for Payer: BCBS Complete |
$896.16
|
| Rate for Payer: BCBS MAPPO |
$1,335.59
|
| Rate for Payer: BCN Commercial |
$2,105.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,335.59
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cofinity Commercial |
$1,789.69
|
| Rate for Payer: Cofinity Commercial |
$1,923.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,335.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,402.37
|
| Rate for Payer: Meridian Medicaid |
$896.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,469.15
|
| Rate for Payer: Nomi Health Commercial |
$1,602.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,423.75
|
| Rate for Payer: PACE SWMI |
$1,335.59
|
| Rate for Payer: PHP Commercial |
$1,869.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,335.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$853.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,446.03
|
| Rate for Payer: Priority Health Medicare |
$1,335.59
|
| Rate for Payer: Priority Health SBD |
$2,446.03
|
| Rate for Payer: Priority Health Tiered Network |
$2,446.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,335.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,430.29
|
| Rate for Payer: UHC Core |
$2,430.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,335.59
|
| Rate for Payer: UHC Exchange |
$2,430.29
|
| Rate for Payer: UHC Medicaid |
$853.49
|
| Rate for Payer: UHCCP Medicaid |
$853.49
|
| Rate for Payer: UMR Bronson Commercial |
$3,939.90
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES
|
Professional
|
Both
|
$8,565.00
|
|
|
Service Code
|
HCPCS 61796
|
| Min. Negotiated Rate |
$645.82 |
| Max. Negotiated Rate |
$6,423.75 |
| Rate for Payer: Aetna Commercial |
$1,346.77
|
| Rate for Payer: Aetna Medicare |
$1,045.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,346.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,447.27
|
| Rate for Payer: BCBS Complete |
$678.11
|
| Rate for Payer: BCBS MAPPO |
$1,005.05
|
| Rate for Payer: BCN Commercial |
$1,561.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,005.05
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cofinity Commercial |
$1,346.77
|
| Rate for Payer: Cofinity Commercial |
$1,447.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,005.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,055.30
|
| Rate for Payer: Meridian Medicaid |
$678.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,105.56
|
| Rate for Payer: Nomi Health Commercial |
$1,206.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,423.75
|
| Rate for Payer: PACE SWMI |
$1,005.05
|
| Rate for Payer: PHP Commercial |
$1,407.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,005.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,813.86
|
| Rate for Payer: Priority Health Medicare |
$1,005.05
|
| Rate for Payer: Priority Health SBD |
$1,813.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,813.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,005.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,781.22
|
| Rate for Payer: UHC Core |
$1,781.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,005.05
|
| Rate for Payer: UHC Exchange |
$1,781.22
|
| Rate for Payer: UHC Medicaid |
$645.82
|
| Rate for Payer: UHCCP Medicaid |
$645.82
|
| Rate for Payer: UMR Bronson Commercial |
$3,939.90
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SPINAL LESION
|
Professional
|
Both
|
$2,406.00
|
|
|
Service Code
|
HCPCS 63620
|
| Min. Negotiated Rate |
$709.93 |
| Max. Negotiated Rate |
$2,002.41 |
| Rate for Payer: Aetna Commercial |
$1,483.07
|
| Rate for Payer: Aetna Medicare |
$1,151.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,483.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,593.75
|
| Rate for Payer: BCBS Complete |
$745.43
|
| Rate for Payer: BCBS MAPPO |
$1,106.77
|
| Rate for Payer: BCN Commercial |
$1,724.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,106.77
|
| Rate for Payer: Cash Price |
$1,924.80
|
| Rate for Payer: Cash Price |
$1,924.80
|
| Rate for Payer: Cofinity Commercial |
$1,483.07
|
| Rate for Payer: Cofinity Commercial |
$1,593.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,106.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,162.11
|
| Rate for Payer: Meridian Medicaid |
$745.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,217.45
|
| Rate for Payer: Nomi Health Commercial |
$1,328.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,804.50
|
| Rate for Payer: PACE SWMI |
$1,106.77
|
| Rate for Payer: PHP Commercial |
$1,549.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,106.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$709.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,002.41
|
| Rate for Payer: Priority Health Medicare |
$1,106.77
|
| Rate for Payer: Priority Health SBD |
$2,002.41
|
| Rate for Payer: Priority Health Tiered Network |
$2,002.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,106.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,968.55
|
| Rate for Payer: UHC Core |
$1,968.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,106.77
|
| Rate for Payer: UHC Exchange |
$1,968.55
|
| Rate for Payer: UHC Medicaid |
$709.93
|
| Rate for Payer: UHCCP Medicaid |
$709.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.76
|
|
|
PR STERILE SALINE OR WATER
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS A4218
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna Commercial |
$1.75
|
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.75
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCN Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: UMR Bronson Commercial |
$0.92
|
|
|
PR STERNAL DEBRIDEMENT
|
Professional
|
Both
|
$4,272.00
|
|
|
Service Code
|
HCPCS 21627
|
| Min. Negotiated Rate |
$354.22 |
| Max. Negotiated Rate |
$3,204.00 |
| Rate for Payer: Aetna Commercial |
$723.72
|
| Rate for Payer: Aetna Medicare |
$561.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.73
|
| Rate for Payer: BCBS Complete |
$371.93
|
| Rate for Payer: BCBS MAPPO |
$540.09
|
| Rate for Payer: BCN Commercial |
$830.13
|
| Rate for Payer: BCN Medicare Advantage |
$540.09
|
| Rate for Payer: Cash Price |
$3,417.60
|
| Rate for Payer: Cash Price |
$3,417.60
|
| Rate for Payer: Cofinity Commercial |
$777.73
|
| Rate for Payer: Cofinity Commercial |
$723.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$540.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$567.09
|
| Rate for Payer: Meridian Medicaid |
$371.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$594.10
|
| Rate for Payer: Nomi Health Commercial |
$648.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,204.00
|
| Rate for Payer: PACE SWMI |
$540.09
|
| Rate for Payer: PHP Commercial |
$756.13
|
| Rate for Payer: PHP Medicare Advantage |
$540.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$354.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$887.40
|
| Rate for Payer: Priority Health Medicare |
$540.09
|
| Rate for Payer: Priority Health SBD |
$887.40
|
| Rate for Payer: Priority Health Tiered Network |
$887.40
|
| Rate for Payer: Railroad Medicare Medicare |
$540.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.41
|
| Rate for Payer: UHC Core |
$941.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$540.09
|
| Rate for Payer: UHC Exchange |
$941.41
|
| Rate for Payer: UHC Medicaid |
$354.22
|
| Rate for Payer: UHCCP Medicaid |
$354.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,965.12
|
|
|
PR STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$1,176.00
|
|
|
Service Code
|
HCPCS 59525
|
| Min. Negotiated Rate |
$271.79 |
| Max. Negotiated Rate |
$882.00 |
| Rate for Payer: Aetna Commercial |
$579.63
|
| Rate for Payer: Aetna Medicare |
$449.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$579.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.89
|
| Rate for Payer: BCBS Complete |
$285.38
|
| Rate for Payer: BCBS MAPPO |
$432.56
|
| Rate for Payer: BCN Commercial |
$717.59
|
| Rate for Payer: BCN Medicare Advantage |
$432.56
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cash Price |
$940.80
|
| Rate for Payer: Cofinity Commercial |
$579.63
|
| Rate for Payer: Cofinity Commercial |
$622.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$432.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$454.19
|
| Rate for Payer: Meridian Medicaid |
$285.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$475.82
|
| Rate for Payer: Nomi Health Commercial |
$519.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.00
|
| Rate for Payer: PACE SWMI |
$432.56
|
| Rate for Payer: PHP Commercial |
$605.58
|
| Rate for Payer: PHP Medicare Advantage |
$432.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$271.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$677.40
|
| Rate for Payer: Priority Health Medicare |
$432.56
|
| Rate for Payer: Priority Health SBD |
$677.40
|
| Rate for Payer: Priority Health Tiered Network |
$677.40
|
| Rate for Payer: Railroad Medicare Medicare |
$432.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$868.09
|
| Rate for Payer: UHC Core |
$868.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$432.56
|
| Rate for Payer: UHC Exchange |
$868.09
|
| Rate for Payer: UHC Medicaid |
$271.79
|
| Rate for Payer: UHCCP Medicaid |
$271.79
|
| Rate for Payer: UMR Bronson Commercial |
$540.96
|
|
|
PR STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC
|
Professional
|
Both
|
$1,488.00
|
|
|
Service Code
|
HCPCS 67311
|
| Min. Negotiated Rate |
$249.42 |
| Max. Negotiated Rate |
$1,116.00 |
| Rate for Payer: Aetna Commercial |
$505.37
|
| Rate for Payer: Aetna Medicare |
$392.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.08
|
| Rate for Payer: BCBS Complete |
$261.89
|
| Rate for Payer: BCBS MAPPO |
$377.14
|
| Rate for Payer: BCN Commercial |
$676.26
|
| Rate for Payer: BCN Medicare Advantage |
$377.14
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cofinity Commercial |
$505.37
|
| Rate for Payer: Cofinity Commercial |
$543.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.00
|
| Rate for Payer: Meridian Medicaid |
$261.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$414.85
|
| Rate for Payer: Nomi Health Commercial |
$452.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,116.00
|
| Rate for Payer: PACE SWMI |
$377.14
|
| Rate for Payer: PHP Commercial |
$528.00
|
| Rate for Payer: PHP Medicare Advantage |
$377.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$792.14
|
| Rate for Payer: Priority Health Medicare |
$377.14
|
| Rate for Payer: Priority Health SBD |
$792.14
|
| Rate for Payer: Priority Health Tiered Network |
$792.14
|
| Rate for Payer: Railroad Medicare Medicare |
$377.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.94
|
| Rate for Payer: UHC Core |
$1,014.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$377.14
|
| Rate for Payer: UHC Exchange |
$1,014.94
|
| Rate for Payer: UHC Medicaid |
$249.42
|
| Rate for Payer: UHCCP Medicaid |
$249.42
|
| Rate for Payer: UMR Bronson Commercial |
$684.48
|
|
|
PR STRAIGHT TIP URINE CATHETER
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4351
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Aetna Commercial |
$3.46
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.72
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$2.58
|
| Rate for Payer: BCN Commercial |
$2.47
|
| Rate for Payer: BCN Medicare Advantage |
$2.58
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$3.46
|
| Rate for Payer: Cofinity Commercial |
$3.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.84
|
| Rate for Payer: Nomi Health Commercial |
$3.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
| Rate for Payer: PACE SWMI |
$2.58
|
| Rate for Payer: PHP Commercial |
$3.61
|
| Rate for Payer: PHP Medicare Advantage |
$2.58
|
| Rate for Payer: Priority Health Medicare |
$2.58
|
| Rate for Payer: Railroad Medicare Medicare |
$2.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.84
|
| Rate for Payer: UHC Core |
$0.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.58
|
| Rate for Payer: UHC Exchange |
$0.84
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
PR STRAPPING ANKLE &/FOOT
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 29540
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$20.57
|
| Rate for Payer: Aetna Medicare |
$15.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.57
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$15.35
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: BCN Medicare Advantage |
$15.35
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$22.10
|
| Rate for Payer: Cofinity Commercial |
$20.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.12
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.89
|
| Rate for Payer: Nomi Health Commercial |
$18.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.00
|
| Rate for Payer: PACE SWMI |
$15.35
|
| Rate for Payer: PHP Commercial |
$21.49
|
| Rate for Payer: PHP Medicare Advantage |
$15.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.68
|
| Rate for Payer: Priority Health Medicare |
$15.35
|
| Rate for Payer: Priority Health SBD |
$27.68
|
| Rate for Payer: Priority Health Tiered Network |
$27.68
|
| Rate for Payer: Railroad Medicare Medicare |
$15.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.55
|
| Rate for Payer: UHC Core |
$31.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.35
|
| Rate for Payer: UHC Exchange |
$31.55
|
| Rate for Payer: UHC Medicaid |
$9.80
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
PR STRAPPING ELBOW/WRIST
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 29260
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$45.75 |
| Rate for Payer: Aetna Commercial |
$20.88
|
| Rate for Payer: Aetna Medicare |
$16.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.44
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$15.58
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: BCN Medicare Advantage |
$15.58
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$20.88
|
| Rate for Payer: Cofinity Commercial |
$22.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.36
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$18.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$15.58
|
| Rate for Payer: PHP Commercial |
$21.81
|
| Rate for Payer: PHP Medicare Advantage |
$15.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.80
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health SBD |
$29.80
|
| Rate for Payer: Priority Health Tiered Network |
$29.80
|
| Rate for Payer: Railroad Medicare Medicare |
$15.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.42
|
| Rate for Payer: UHC Core |
$34.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.58
|
| Rate for Payer: UHC Exchange |
$34.42
|
| Rate for Payer: UHC Medicaid |
$10.01
|
| Rate for Payer: UHCCP Medicaid |
$10.01
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR STRAPPING HAND/FINGER
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 29280
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Aetna Commercial |
$22.71
|
| Rate for Payer: Aetna Medicare |
$17.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$16.95
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$16.95
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$22.71
|
| Rate for Payer: Cofinity Commercial |
$24.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.80
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.64
|
| Rate for Payer: Nomi Health Commercial |
$20.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$16.95
|
| Rate for Payer: PHP Commercial |
$23.73
|
| Rate for Payer: PHP Medicare Advantage |
$16.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$31.40
|
| Rate for Payer: Priority Health Medicare |
$16.95
|
| Rate for Payer: Priority Health SBD |
$31.40
|
| Rate for Payer: Priority Health Tiered Network |
$31.40
|
| Rate for Payer: Railroad Medicare Medicare |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.82
|
| Rate for Payer: UHC Core |
$36.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.95
|
| Rate for Payer: UHC Exchange |
$36.82
|
| Rate for Payer: UHC Medicaid |
$10.86
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
| Rate for Payer: UMR Bronson Commercial |
$48.76
|
|
|
PR STRAPPING TOES
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 29550
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$45.75 |
| Rate for Payer: Aetna Commercial |
$12.98
|
| Rate for Payer: Aetna Medicare |
$10.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.95
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$9.69
|
| Rate for Payer: BCN Commercial |
$12.96
|
| Rate for Payer: BCN Medicare Advantage |
$9.69
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$12.98
|
| Rate for Payer: Cofinity Commercial |
$13.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.17
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$11.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$9.69
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.56
|
| Rate for Payer: Priority Health Medicare |
$9.69
|
| Rate for Payer: Priority Health SBD |
$17.56
|
| Rate for Payer: Priority Health Tiered Network |
$17.56
|
| Rate for Payer: Railroad Medicare Medicare |
$9.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.39
|
| Rate for Payer: UHC Core |
$20.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.69
|
| Rate for Payer: UHC Exchange |
$20.39
|
| Rate for Payer: UHC Medicaid |
$6.18
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR STRAPPING UNNA BOOT
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 29580
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna Commercial |
$31.38
|
| Rate for Payer: Aetna Medicare |
$24.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.72
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$23.42
|
| Rate for Payer: BCN Commercial |
$30.63
|
| Rate for Payer: BCN Medicare Advantage |
$23.42
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$31.38
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.59
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.76
|
| Rate for Payer: Nomi Health Commercial |
$28.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.50
|
| Rate for Payer: PACE SWMI |
$23.42
|
| Rate for Payer: PHP Commercial |
$32.79
|
| Rate for Payer: PHP Medicare Advantage |
$23.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.52
|
| Rate for Payer: Priority Health Medicare |
$23.42
|
| Rate for Payer: Priority Health SBD |
$41.52
|
| Rate for Payer: Priority Health Tiered Network |
$41.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.75
|
| Rate for Payer: UHC Core |
$48.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.42
|
| Rate for Payer: UHC Exchange |
$48.75
|
| Rate for Payer: UHC Medicaid |
$14.91
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
| Rate for Payer: UMR Bronson Commercial |
$45.08
|
|
|
PR STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR
|
Professional
|
Both
|
$7,245.00
|
|
|
Service Code
|
HCPCS 61751
|
| Min. Negotiated Rate |
$884.16 |
| Max. Negotiated Rate |
$5,433.75 |
| Rate for Payer: Aetna Commercial |
$1,842.02
|
| Rate for Payer: Aetna Medicare |
$1,429.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,842.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,979.48
|
| Rate for Payer: BCBS Complete |
$928.37
|
| Rate for Payer: BCBS MAPPO |
$1,374.64
|
| Rate for Payer: BCN Commercial |
$2,934.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,374.64
|
| Rate for Payer: Cash Price |
$5,796.00
|
| Rate for Payer: Cash Price |
$5,796.00
|
| Rate for Payer: Cofinity Commercial |
$1,842.02
|
| Rate for Payer: Cofinity Commercial |
$1,979.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,374.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,443.37
|
| Rate for Payer: Meridian Medicaid |
$928.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,512.10
|
| Rate for Payer: Nomi Health Commercial |
$1,649.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,433.75
|
| Rate for Payer: PACE SWMI |
$1,374.64
|
| Rate for Payer: PHP Commercial |
$1,924.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,374.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$884.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,466.86
|
| Rate for Payer: Priority Health Medicare |
$1,374.64
|
| Rate for Payer: Priority Health SBD |
$2,466.86
|
| Rate for Payer: Priority Health Tiered Network |
$2,466.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,374.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,421.65
|
| Rate for Payer: UHC Core |
$2,421.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,374.64
|
| Rate for Payer: UHC Exchange |
$2,421.65
|
| Rate for Payer: UHC Medicaid |
$884.16
|
| Rate for Payer: UHCCP Medicaid |
$884.16
|
| Rate for Payer: UMR Bronson Commercial |
$3,332.70
|
|
|
PR STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 61781
|
| Min. Negotiated Rate |
$137.17 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$292.01
|
| Rate for Payer: Aetna Medicare |
$226.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.80
|
| Rate for Payer: BCBS Complete |
$144.03
|
| Rate for Payer: BCBS MAPPO |
$217.92
|
| Rate for Payer: BCN Commercial |
$354.07
|
| Rate for Payer: BCN Medicare Advantage |
$217.92
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$292.01
|
| Rate for Payer: Cofinity Commercial |
$313.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.82
|
| Rate for Payer: Meridian Medicaid |
$144.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.71
|
| Rate for Payer: Nomi Health Commercial |
$261.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$217.92
|
| Rate for Payer: PHP Commercial |
$305.09
|
| Rate for Payer: PHP Medicare Advantage |
$217.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$411.23
|
| Rate for Payer: Priority Health Medicare |
$217.92
|
| Rate for Payer: Priority Health SBD |
$411.23
|
| Rate for Payer: Priority Health Tiered Network |
$411.23
|
| Rate for Payer: Railroad Medicare Medicare |
$217.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.38
|
| Rate for Payer: UHC Core |
$418.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.92
|
| Rate for Payer: UHC Exchange |
$418.38
|
| Rate for Payer: UHC Medicaid |
$137.17
|
| Rate for Payer: UHCCP Medicaid |
$137.17
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 61782
|
| Min. Negotiated Rate |
$92.02 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna Commercial |
$193.05
|
| Rate for Payer: Aetna Medicare |
$149.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.46
|
| Rate for Payer: BCBS Complete |
$96.62
|
| Rate for Payer: BCBS MAPPO |
$144.07
|
| Rate for Payer: BCN Commercial |
$257.45
|
| Rate for Payer: BCN Medicare Advantage |
$144.07
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$193.05
|
| Rate for Payer: Cofinity Commercial |
$207.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.27
|
| Rate for Payer: Meridian Medicaid |
$96.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.48
|
| Rate for Payer: Nomi Health Commercial |
$172.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$573.75
|
| Rate for Payer: PACE SWMI |
$144.07
|
| Rate for Payer: PHP Commercial |
$201.70
|
| Rate for Payer: PHP Medicare Advantage |
$144.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$299.03
|
| Rate for Payer: Priority Health Medicare |
$144.07
|
| Rate for Payer: Priority Health SBD |
$299.03
|
| Rate for Payer: Priority Health Tiered Network |
$299.03
|
| Rate for Payer: Railroad Medicare Medicare |
$144.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$307.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$144.07
|
| Rate for Payer: UHC Exchange |
$307.27
|
| Rate for Payer: UHC Medicaid |
$92.02
|
| Rate for Payer: UHCCP Medicaid |
$92.02
|
| Rate for Payer: UMR Bronson Commercial |
$351.90
|
|
|
PR STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX
|
Professional
|
Both
|
$8,565.00
|
|
|
Service Code
|
HCPCS 61799
|
| Min. Negotiated Rate |
$175.73 |
| Max. Negotiated Rate |
$6,423.75 |
| Rate for Payer: Aetna Commercial |
$374.05
|
| Rate for Payer: Aetna Medicare |
$290.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$401.96
|
| Rate for Payer: BCBS Complete |
$184.52
|
| Rate for Payer: BCBS MAPPO |
$279.14
|
| Rate for Payer: BCN Commercial |
$454.16
|
| Rate for Payer: BCN Medicare Advantage |
$279.14
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cofinity Commercial |
$374.05
|
| Rate for Payer: Cofinity Commercial |
$401.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.10
|
| Rate for Payer: Meridian Medicaid |
$184.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.05
|
| Rate for Payer: Nomi Health Commercial |
$334.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,423.75
|
| Rate for Payer: PACE SWMI |
$279.14
|
| Rate for Payer: PHP Commercial |
$390.80
|
| Rate for Payer: PHP Medicare Advantage |
$279.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$527.50
|
| Rate for Payer: Priority Health Medicare |
$279.14
|
| Rate for Payer: Priority Health SBD |
$527.50
|
| Rate for Payer: Priority Health Tiered Network |
$527.50
|
| Rate for Payer: Railroad Medicare Medicare |
$279.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.43
|
| Rate for Payer: UHC Core |
$539.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$279.14
|
| Rate for Payer: UHC Exchange |
$539.43
|
| Rate for Payer: UHC Medicaid |
$175.73
|
| Rate for Payer: UHCCP Medicaid |
$175.73
|
| Rate for Payer: UMR Bronson Commercial |
$3,939.90
|
|
|
PR STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE
|
Professional
|
Both
|
$8,565.00
|
|
|
Service Code
|
HCPCS 61797
|
| Min. Negotiated Rate |
$127.59 |
| Max. Negotiated Rate |
$6,423.75 |
| Rate for Payer: Aetna Commercial |
$271.70
|
| Rate for Payer: Aetna Medicare |
$210.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$271.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.97
|
| Rate for Payer: BCBS Complete |
$133.97
|
| Rate for Payer: BCBS MAPPO |
$202.76
|
| Rate for Payer: BCN Commercial |
$329.17
|
| Rate for Payer: BCN Medicare Advantage |
$202.76
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cash Price |
$6,852.00
|
| Rate for Payer: Cofinity Commercial |
$271.70
|
| Rate for Payer: Cofinity Commercial |
$291.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$212.90
|
| Rate for Payer: Meridian Medicaid |
$133.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.04
|
| Rate for Payer: Nomi Health Commercial |
$243.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,423.75
|
| Rate for Payer: PACE SWMI |
$202.76
|
| Rate for Payer: PHP Commercial |
$283.86
|
| Rate for Payer: PHP Medicare Advantage |
$202.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$382.32
|
| Rate for Payer: Priority Health Medicare |
$202.76
|
| Rate for Payer: Priority Health SBD |
$382.32
|
| Rate for Payer: Priority Health Tiered Network |
$382.32
|
| Rate for Payer: Railroad Medicare Medicare |
$202.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.13
|
| Rate for Payer: UHC Core |
$390.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$202.76
|
| Rate for Payer: UHC Exchange |
$390.13
|
| Rate for Payer: UHC Medicaid |
$127.59
|
| Rate for Payer: UHCCP Medicaid |
$127.59
|
| Rate for Payer: UMR Bronson Commercial |
$3,939.90
|
|
|
PR SUBCUTANEOUS HORMONE PELLET IMPLANTATION
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 11980
|
| Min. Negotiated Rate |
$30.89 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$64.87
|
| Rate for Payer: Aetna Medicare |
$50.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.71
|
| Rate for Payer: BCBS Complete |
$32.43
|
| Rate for Payer: BCBS MAPPO |
$48.41
|
| Rate for Payer: BCN Commercial |
$82.17
|
| Rate for Payer: BCN Medicare Advantage |
$48.41
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$64.87
|
| Rate for Payer: Cofinity Commercial |
$69.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.83
|
| Rate for Payer: Meridian Medicaid |
$32.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.25
|
| Rate for Payer: Nomi Health Commercial |
$58.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$48.41
|
| Rate for Payer: PHP Commercial |
$67.77
|
| Rate for Payer: PHP Medicare Advantage |
$48.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.20
|
| Rate for Payer: Priority Health Medicare |
$48.41
|
| Rate for Payer: Priority Health SBD |
$75.20
|
| Rate for Payer: Priority Health Tiered Network |
$75.20
|
| Rate for Payer: Railroad Medicare Medicare |
$48.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.06
|
| Rate for Payer: UHC Core |
$99.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.41
|
| Rate for Payer: UHC Exchange |
$99.06
|
| Rate for Payer: UHC Medicaid |
$30.89
|
| Rate for Payer: UHCCP Medicaid |
$30.89
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
|
